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研究生:馬佳吟
研究生(外文):Jia-Yin Ma
論文名稱:乳癌患者與其伴侶之溝通模式、關係品質與生活品質
論文名稱(外文):The communication patterns, quality of relationship, and quality of life among breast cancer patient and their couples
指導教授:黃君瑜黃君瑜引用關係
指導教授(外文):Chun-Yu Huang
學位類別:碩士
校院名稱:中原大學
系所名稱:心理學研究所
學門:社會及行為科學學門
學類:心理學類
論文種類:學術論文
論文出版年:2014
畢業學年度:102
語文別:中文
論文頁數:88
中文關鍵詞:乳癌生活品質伴侶溝通模式關係品質
外文關鍵詞:cancer-related communication patternquality of relationshipbreast cancerquality of life
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伴侶之間互相支持與陪伴,在伴侶任一方生病後,雙方需要共同面對因應疾病,因為疾病而引起的相關問題,皆可能影響病患及其伴侶之間的生活。本研究探討乳癌病患與其伴侶雙方面對疾病的適應歷程,包括使用的溝通模式、知覺到的關係品質與生活品質,亦以對偶分析探討伴侶之間相互性的影響。研究採取橫斷式設計,研究對象為257位乳癌病患與133位伴侶,每位受試者須填寫個人基本資料、中文版溝通模式量表、中文版配偶調適量表與台灣簡明版世界衛生組織生活品質問卷,透過相關分析、差異分析、對偶分析與多元迴歸分析,結果發現1.伴侶參與研究的病患知覺到與伴侶之間有較多建設性溝通且較少相互逃避溝通,且明顯較滿意雙方關係,在填答伴侶是自己主要照顧者的病患中亦發現同樣結果; 2.臨床疾病變項對病患生活品質影響很低,個人變項上則是發現當病患停經時間越久,其生活品質越差; 3.不論是病患或其伴侶,若知覺到較多建設性溝通者有較滿意的關係品質,且對關係較滿意者有較好的生活品質。若知覺雙方的溝通傾向相互逃避或者一方要求-一方退縮者較不滿意彼此的關係,而不滿意關係者有較差的生活品質; 4.運用主-客體相依模式分析發現,自身知覺溝通模式會影響自身關係品質,且同時男性伴侶的關係品質受到女性病患所知覺到的溝通模式影響; 5.關係品質是溝通模式與生活品質的中介變項,在病患中完全中介溝通與生活品質之間的影響,包括生理健康、心理健康、社會關係與環境,而關係品質在伴侶中則中介溝通對心理健康的影響。本研究認為,疾病的確對伴侶關係有所影響,因此在探討一方生病的伴侶關係時,需同時納入性別差異與疾病的影響討論,此外,對癌症病患與其伴侶來說,除了提供醫療協助以外,可鼓勵伴侶陪伴病患就醫、擔任其主要照顧者或者對病患提供更多協助,臨床心理專業方面可多了解並協助提升伴侶之間溝通技巧與關係品質,以期提升病患與其伴侶的生活品質。

In the couple relationship, one supports and accompanies with the other partner. If one of them gets illness, both sides need to face the disease together. The disease-related problems are likely to affect the life of patients and their partners. Thus, this study aims to consider the adaptation process of disease within breast cancer patients and their partners, including communication pattern, the perceived quality of the relationship and quality of life. We also use dual analysis to explore the reciprocity of couple. This study is a cross-sectional design, and 257 breast cancer patients and their partners are participated. Each subject completed the basic information questionnaire, Communication Pattern Questionnaire, Dyadic Adjustment Scale and WHOQOL-BREF, Taiwan version. As analysis methods, we applied correlation analysis, difference analysis, multiple regression analysis and dyadic data analysis through the actor-partner interdependence model (APIM). The results revealed the points as followed: 1.The patients with partner have participated in this study perceive more mutual constructive and less mutual avoidance communication; also, they identify more satisfaction with the quality of relationship. In addition, we found the same results from those patients who responded her partner is the primary caregiver. 2. The influence of clinical disease variables over the quality of life for patients is not significant. However, for the personal variable aspect, the study pointed out that the longer patients have been through menopause, the worse the quality of life is. 3. Whether the patients themselves or their partners perceived having a more constructive communication, they will have more satisfactory quality of relationship. And they have more satisfaction with the relationship will have a better quality of life. Once they perceived having a more mutual avoidance of discussion or demand-withdraw of discussion, they will have less satisfactory quality of relationship. Furthermore, for those who have less satisfaction with the relationship will have a worse quality of life. 4. By using the APIM, the consequence revealed that the cancer-related communication pattern of each person is the strongest predictor of their own quality of relationship. The communication pattern of woman breast cancer patient’s perception also plays a significant role on their male partner’s quality of relationship. 5. Quality of relationship is a mediator variable between the cancer-related communication patterns and quality of life. For patients, quality of relationship is consistent with full mediated between the cancer-related communication patterns and all domain of quality of life. On the other hands, quality of relationship is full mediated between the cancer-related communication patterns and psychological health domain of quality of life for the partners. In conclusion, disease does have an impact on relationship. Therefore, when exploring the relationship which has one partner gets illness, it required to incorporate the impact of gender differences and disease impact. Besides, for cancer patients and their partners, we encourage partners to accompany patients for medical treatment, be patient’s primary caregiver, and provide more assistance to patients. To improve the quality of life of patients and their partners, clinicians should be aware of the communication between the patients and their partners in order to help them to improve their communication skills and the quality of their relationship.

摘要 I
Abstract II
誌謝 III
目錄 IV
圖目錄 VI
表目錄 VII
第一章 研究動機與目的 1
第二章 文獻探討 3
第一節 乳房癌症 3
一、 乳癌特性 3
二、 乳癌患者的生活品質 4
第二節 伴侶溝通模式 4
一、 伴侶溝通的概念及模式 5
二、 伴侶溝通模式的測量 5
第三節 關係品質 7
一、 關係品質的概念 7
二、 關係品質的測量 8
第四節 生活品質 8
一、 生活品質的概念 9
二、 生活品質的測量 9
第五節 伴侶溝通模式、關係品質及生活品質的關係 10
一、 伴侶溝通模式及關係品質的關係 10
二、 關係品質與生活品質的關係 12
三、 伴侶溝通模式、關係品質及生活品質的關係 12
第六節 研究架構與假設 17
一、 研究架構 17
二、 研究假設 17
第三章 研究方法 18
第一節 研究對象 18
第二節 研究工具 24
一、 基本資料 24
二、 溝通模式量表 24
三、 關係品質量表 26
四、 生活品質量表 27
第三節 研究程序 28
第四節 資料分析 28
第四章 研究結果 30
第一節 個人變項與臨床疾病變項之相關與差異分析 30
一、 分組探討個人變項、臨床疾病變項、溝通模式、關係品質與生活品質之差異分析 30
二、 個人變項在溝通模式、關係品質與生活品質之相關與差異分析 33
三、 臨床疾病變項在溝通模式、關係品質與生活品質之差異分析 38
第二節 溝通模式、關係品質與生活品質變項之相關 41
一、 溝通模式與關係品質之相關 41
二、 關係品質與生活品質之相關 44
三、 溝通模式與生活品質之相關 47
第三節 溝通模式與關係品質的影響歷程 49
一、 溝通模式與關係品質在病患與其伴侶之間的差異分析 49
二、 溝通模式對關係品質影響歷程 50
第四節 關係品質中介溝通模式預測生活品質之迴歸分析 51
一、 關係品質中介溝通模式預測生活品質各範疇之迴歸分析(病患樣本) 51
二、 關係品質中介溝通模式預測生活品質各範疇之迴歸分析(伴侶樣本) 53
第五章 討論與建議 57
第一節 研究結果討論 57
一、 乳癌病患人口學、疾病特性與溝通模式、關係品質及生活品質的相關與差異 57
二、 溝通模式對關係品質的影響歷程 58
三、 關係品質在溝通模式與生活品質之間的中介效果 59
第二節 研究限制及未來研究建議 61
一、 研究方法 61
二、 研究對象 61
第三節 研究貢獻及臨床應用 61
參考文獻 63
附錄一 溝通模式、關係品質與生活品質問卷(病患版) 69
附錄二 溝通模式、關係品質與生活品質問卷(家屬版) 78
附錄三 溝通模式調查問卷使用授權書 86
附錄四 配偶調適量表使用授權書 87
附錄五 台灣版世界衛生組織生活品質問卷使用授權書 88

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